Kruse J A, Thill-Baharozian M C, Carlson R W
Department of Medicine, Wayne State University School of Medicine, Detroit, MI.
JAMA. 1988;260(12):1739-42.
The APACHE II (Acute Physiology and Chronic Health Evaluation) system has been widely used as an objective means of predicting outcome in critically ill patients. We prospectively evaluated patients consecutively admitted to the medical intensive care unit to compare the predictive accuracy of APACHE II with clinical assessment by critical care personnel. At the time of admission to the intensive care unit, the house staff and nurse responsible for each patient were asked to estimate the patient's hospital mortality risk. The patient's APACHE II score was calculated and a prediction of the patient's hospital mortality risk was then computed on the basis of this score. A total of 366 patients were studied. Mortality predictions were obtained from 57 physicians and 33 critical care nurses. We were unable to demonstrate a significant difference in the accuracy of APACHE II predictions compared with either physicians' or nurses' predictions. Clinical assessment and APACHE II were both highly predictive of outcome.
急性生理学与慢性健康状况评估系统（APACHE II）已被广泛用作预测重症患者预后的客观手段。我们对连续入住内科重症监护病房的患者进行了前瞻性评估，以比较APACHE II与重症监护人员临床评估的预测准确性。在患者入住重症监护病房时，要求负责每位患者的住院医生和护士估计患者的医院死亡风险。计算患者的APACHE II评分，并基于该评分计算患者医院死亡风险的预测值。共研究了366例患者。从57名医生和33名重症监护护士处获得了死亡预测。与医生或护士的预测相比，我们未能证明APACHE II预测的准确性存在显著差异。临床评估和APACHE II对预后均具有高度预测性。
